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| Name | Class |
|---|---|
| University of Zurich | OTHER |
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This study evaluates the effects of additional sensorimotor training (proprioceptive postural training, PPT) to conventional therapy in the treatment of chronic low-back pain. Half of the participants will receive instructed treadmill training as an active comparator against PPT. All participants receive conventional physiotherapy as prescribed by their treating medical doctors. It is expected that the PPT group will improve in postural control, proprioceptive, as well as pain and function outcomes to a significantly greater extent than the active control group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sensorimotor | Experimental | The experimental group will receive added PPT to the conventional physiotherapy. PPT will be applied by means of a neuro-orthopaedic medical device ("Posturomed®", see section 3.2). The "Posturomed" allows adaptive oscillation in the horizontal plane. Therapy instructions advise seven stages of difficulty. In all stages the patient is asked to provoke oscillation by stepping on site. After three steps, the patient must stand still on one leg for 2 seconds before he or she repeats the steps. Difficulty is increased by a) decreasing the damping through release of the breaks and b) through added juggling of a ball during the motor task (dual-task and divided attention). The next stage is reached once stabilisation in the previous stage is secured. |
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| Low-intensity activity | Active Comparator | Added to conventional therapy, as administered to all participants, the control group will do added treadmill walking. The control intervention will consist of 10 minutes of walking at comfortable pace. The patient will be instructed in treadmill functions and asked to set the speed between 2 and 4 km/h. The speed should be adjusted to the level where the patient would still be able to talk comfortably. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Proprioceptive postural training | Other |
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| Measure | Description | Time Frame |
|---|---|---|
| Change of self-reported pain on 100mm Visual Analogue Scale (VAS) | Baseline (-4 days); Pre-Test (0 days); Post-Test (+25 days) and follow-up (+45 days) | |
| Change of functional status recorded with the Oswestry Disability Index (ODI) | Baseline (-4 days); Pre-Test (0 days); Post-Test (+25 days) and follow-up (+45 days) |
| Measure | Description | Time Frame |
|---|---|---|
| Centre of Pressure | Area of surface a the 95% confidence ellipse of centre of pressure displacement during postural task | Baseline (-4 days); Pre-Test (0 days); Post-Test (+25 days) and follow-up (+45 days) |
| Joint Repositioning Error (segmental) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michael A McCaskey, MSc | Reha Rheinfelden | Principal Investigator |
| Eling D. de Bruin, PD PhD | ETH Zurich | Study Chair |
| Corina Schuster-Amft, PT PhD | Reha Rheinfelden | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Reha Rheinfelden | Rheinfelden | Canton of Aargau | 4310 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10382616 | Background | Scholz JP, Schoner G. The uncontrolled manifold concept: identifying control variables for a functional task. Exp Brain Res. 1999 Jun;126(3):289-306. doi: 10.1007/s002210050738. | |
| 29522571 | Derived | McCaskey MA, Wirth B, Schuster-Amft C, de Bruin ED. Postural sensorimotor training versus sham exercise in physiotherapy of patients with chronic non-specific low back pain: An exploratory randomised controlled trial. PLoS One. 2018 Mar 9;13(3):e0193358. doi: 10.1371/journal.pone.0193358. eCollection 2018. |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| Treadmill training |
| Other |
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| Conventional physiotherapy | Other | All participating patients will attend usual care according to their treatment plan (taking part in the study does not affect the treatment plan). A physiotherapy referral requests 9 treatments, each of which takes 30 minutes. These will take place twice a week for 4.5 weeks. The study protocol does not dictate the content of the physiotherapy sessions themselves, but detailed documentation of provided treatments is required (therapy documentation sheet). Additionally, the aim of the physiotherapy sessions should always include reduction of muscular imbalances and optimisation of posture. |
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Repositioning acuity after surface perturbation.
| Baseline (-4 days); Pre-Test (0 days); Post-Test (+25 days) and follow-up (+45 days) |
| Uncontrolled Manifold Index (UCM) | Segmental joint configuration. | Baseline (-4 days); Pre-Test (0 days); Post-Test (+25 days) and follow-up (+45 days) |
| 26666457 | Derived | McCaskey MA, Schuster-Amft C, Wirth B, de Bruin ED. Effects of postural specific sensorimotor training in patients with chronic low back pain: study protocol for randomised controlled trial. Trials. 2015 Dec 15;16:571. doi: 10.1186/s13063-015-1104-4. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |